SFD (224410)BUILDING PERMIT
R P
DRAINAGE PIPING
-DEPARTMENT OF BUILDING & SAFETY
DRINKING FOUNTAIN
DBL.
URINAL
•
COUNTY OF RIVERSIDE
SMI FE
CONSTRUCTION ESTIMATE----'
r s vt -(ELECTRICAL FEESow--
1 ST FL.
..
SQ. FT.
"" 0
NO. "
SQ.FT.
@
KITCHEN SINK
2ND FL.
J I F I M A I M - J I J A-1 S 1 0-1 ND
SO. FT.1-1:5r
s' f
SHOWER
MOTOR I OR LESS H.P.
POR.
1,2,1740
SQ.FT.
@a"J/ri
SEWAGE DISPOSAL
MOTOR 5 OR LESS H.P.
GAR.
M.H. HOOKUP FEE
GAS PIPING
O %
PERMIT FEE
COMMUNITY
MOTOR 20 OR LESS H.P.
CA SQ. FT. @
WALL SO.FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION i y
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL JiQ HOOD
APPLIANCE fir^
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑S SPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
T COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM '6FORCED ❑ GRAVITY
i
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
K.W. UNITS
SIGN
TRANS-. K W
FORMER D
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SO. FT. @ ¢
SQ. FT. @ 4
SQ. FT. RESID. @ 14
SQ. FT. GARAGE@124
BALANCE OF MIN. FEE
PERMIT FEE
FIELD OFFICE
PLUMBING FEES I DST.,;
P MI N
DRAINAGE PIPING
MOB. HK. FEE MICRO FEE
DRINKING FOUNTAIN
DBL.
URINAL
®
WATER PIPING
SMI FE
FLOOR DRAIN
DBL.
WATER SOFTENER
WASHER (AUTO) ISM)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
J I F I M A I M - J I J A-1 S 1 0-1 ND
LAVATORY
s' f
SHOWER
BATH TUB
WATER HEATER
USE OF BUILDDING /, F.C.
9-1405#
SEWAGE DISPOSAL
�I
HOUSE SEWER
M.H. HOOKUP FEE
GAS PIPING
O %
PERMIT FEE
P MI N
TOTAL FEE
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
10
DBL. ELECT. FEE DBL.
SMI FE
FEE PLUMB�FvE
DBL.
J I F I M A I M - J I J A-1 S 1 0-1 ND
JOB ADDRESS, - -
OWNER - - -- -- - } -
73
�v a'.."0 2. aI
74
ti
USE OF BUILDDING /, F.C.
9-1405#
DATE PERMN(y
75
I - I 17'alu
M.H. HOOKUP FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
FFICE
�'
!
j
40
I
L7--
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION '
�r co"?y
MECHANICAL FEE'
DBL
$
SETBACK LOT SIZE
ZONE
USE NO.
GRP
PE
ICK BY
17
d
F S �PL a�a
J
ITY .
PLAN CHECK FEE
$
BOND AMT.
'PLAN NO. PLAN CHECKER
FINAL DATE
INSPECTOR o
U,
CONSTRUCTION FEE.. ..
DBL
$
aV
NAME OF CONST. LENDER BRANCH
k,9 f 1.G
OFFICE - .NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
p
STATE
SMI FEE
$
-
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMS ED WITHIN 60 DAYS. CESSA-
$
FEE
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC -
CORDANCE-WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
$
TOTAL FEES �..
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CODE OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK M.O. ❑' N.C. ❑
OWNER. CONT ACTOR
j d
J.
RECEIVED BY
ADDRESSADDRESS Y
�0;�*p ap 2 6
SEWAGE SYSTEM
T LL
P
TREES REQUIRED YES
NO
CITY CITY
,OwINFORMATION
/rTj c3✓d'
ly
TEL NO. TEL. NO. LICE E
"
FORM 284.208 (Rev. 11 /72) tZY~``�
uQ
/ d `� >' ! �` r1 W4` / "'o:Ji+C►.